Mind Over Matter Health Services, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MIND OVER MATTER HEALTH SERVICES, INC

Practice address

5406 Whitlock Rd
Baltimore, MD 21229-1020

Phone

(410) 777-8522

NPI assigned

Mar 19, 2022

Last updated

Mar 19, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Asia M Johnson, LCPC, LCAD-ASNPI 1538173588

Title

Ceo

Phone

(410) 982-1353

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Mind Over Matter Health Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Mind Over Matter Health Services, Inc

  dba Asia Johnson LCPC

  • Community/Behavioral Health Agency
  • Randallstown, MD
  • NPI 1003565979
  NPD tax ID
• Mind Over Matter Health Services, Inc

  • Case Manager/Care Coordinator
  • Randallstown, MD
  • NPI 1396432290
  NPD tax ID
• Mind Over Matter Health Services, Inc

  • Behavior Analyst
  • Randallstown, MD
  • NPI 1790472686
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Asia Maria Johnson, M.A, LCPC

  • Professional Counselor
  • Balto, MD
  • NPI 1538173588
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647648000000",
    "number": "1346999216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10016 MARRIOTTSVILLE RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 WHITLOCK RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291020",
            "telephone_number": "410-777-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND OVER MATTER HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-19",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ASIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-982-1353",
        "authorized_official_credential": "LCPC, LCAD-AS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "577200101",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.thegoodreboot.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "5406 Whitlock Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212291020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.